MONTEREY, Calif. — Two Monterey gastroenterologists have had promising results in an ongoing

clinical study aimed at improving the detection and removal of polyps on the right side of the colon.

“Colonoscopies are effective in reducing the occurrence of cancer on the left side of the colon, but may not be as effective on the right side,” says Daniel Luba, MD, medical director of Monterey Bay GI Consultants Medical Group. “This is concerning because polyps on the right side are increasingly recognized as additional precursors to colon cancer.”

Luba and Dr. James DiSario began their research study in January 2010 and reported preliminary results at the Digestive Disease Week meeting in Chicago, the world’s largest gathering of doctors and researchers in gastroenterology and gastrointestinal surgery.

The study is designed to determine the prevalence of right-sided polyps, assess the effectiveness of a specialized removal technique, and to analyze pathology results to better determine the differences between right- and left-sided polyps. Left-sided polyps tend to look like tiny mushrooms, with a small base and larger head. Right-sided polyps tend to be flat, making them harder to detect and remove.

Over a 16-month period, the physicians performed 1,716 colonoscopies at Monterey Bay Endoscopy Center and Community Hospital of the Monterey Peninsula. Three percent of the patients had large, flat, right-sided polyps removed as part of the study, which was approved by Community Hospital’s Institutional Review Board.

While most colonoscopies are performed with a colonoscope that has a single channel, Luba and DiSario use a double-channel colonoscope and inject saline into the flat polyp, lifting it away from the wall of the colon. They then encircle the polyp with a wire snare that is passed through one channel of the scope. Through the second channel of the scope, they pass a forceps to grasp the polyp and gently retract it. Then they resect or cut off the polyp with the snare and remove it with the forceps.

“This technique allows for the removal of flat polyps through an endoscope in a safe and effective manner, in an outpatient setting,” says DiSario, medical director of Endoscopy at Community Hospital. “Otherwise, surgery would be required with cutting through the abdominal wall to reach the affected portion of the colon, and would create the need for a hospital admission for recovery.”

Luba and DiSario are now planning collaboration with pathologists from the University of Utah to evaluate gene mutations in the removed polyps to better understand how they develop into cancers.

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ABOUT COMMUNITY HOSPITAL

Community Hospital of the Monterey Peninsula, established in 1934, has grown and evolved in direct response to the changing healthcare needs of the people it serves. It is a nonprofit healthcare provider with 205 staffed acute-care hospital beds and 28 skilled-nursing beds, delivering a continuum of care from birth to end of life, and every stage in between. It serves the Monterey Peninsula and surrounding communities through locations including the main hospital, outpatient facilities, satellite laboratories, a mental health clinic, a short-term skilled nursing facility, Hospice of the Central Coast, and business offices. Find more information about Community Hospital of the Monterey Peninsula at http://www.chomp.org/